{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T11:40:22Z","timestamp":1774870822520,"version":"3.50.1"},"reference-count":55,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,3,30]],"date-time":"2016-03-30T00:00:00Z","timestamp":1459296000000},"content-version":"vor","delay-in-days":58,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Anterior cervical discectomy and fusion is the most commonly employed surgical technique for treating cervical spondylosis. Although autologous bone grafts are considered the gold standard in achieving fusion, associated short\u2010 and long\u2010term morbidities have led to a search for alternative materials. These have included carbon\u2010fiber, titanium alloy (Ti) and ceramic and polyetheretherketone (<jats:styled-content style=\"fixed-case\">PEEK<\/jats:styled-content>) based implants. Recent attempts to optimize cage implants through using composite designs have combined Ti and <jats:styled-content style=\"fixed-case\">PEEK<\/jats:styled-content>. However, there are few published reports on the clinical and radiological outcomes of commercially available composite cages. Our study aimed to provide and evaluate initial outcomes of a composite Ti\/<jats:styled-content style=\"fixed-case\">PEEK<\/jats:styled-content> cage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective single senior surgeon cohort study, 31 consecutive patients underwent a modified Smith\u2013Robinson technique under general anesthesia and relevant data were collected. The study patients were aged between 18 and 75 years and underwent surgery from November 2013 to May 2014. Indications for surgery included traumatic and degenerative cervical disease that was unsuitable for or unresponsive to conservative management. All cages were between 5 and 8 mm and packed with super critical fluid sterilized allograft and bone marrow aspirate before insertion. Patients were followed\u2010up for a minimum of 12 months. Fusion was assessed using fine cut <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> and anteroposterior and lateral radiographs. Clinical outcomes were measured using a Visual Analogue Scale, Neck Oswestry Disability Index and Patient's Satisfaction Index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six of the original cohort were unavailable for adequate follow\u2010up. The remaining 25 patients (17 men, 8 women; 33 operative levels) were observed for a mean of 14.6 months (range, 12\u201316 months). All operation levels were between C<jats:sub>4<\/jats:sub> and C<jats:sub>7<\/jats:sub>. Single\u2010level operations were performed in 19 patients and additional plating in 14 patients. A fusion rate of 96% was achieved. Patients in both plated and non\u2010plated groups experienced statistically significant improvements; good to excellent outcomes being seen in 92% of patients. There was one complication, namely recurrent laryngeal nerve palsy, which had partially resolved at 6 months follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The present study shows that enhancement of <jats:styled-content style=\"fixed-case\">PEEK<\/jats:styled-content> cages with Ti endplates is a safe and effective treatment with the potential for early osseointegration and early radiological evidence of fusion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12221","type":"journal-article","created":{"date-parts":[[2016,4,1]],"date-time":"2016-04-01T03:17:25Z","timestamp":1459480645000},"page":"19-26","source":"Crossref","is-referenced-by-count":31,"title":["Titanium\/Polyetheretherketone Cages for Cervical Arthrodesis with Degenerative and Traumatic Pathologies: Early Clinical Outcomes and Fusion Rates"],"prefix":"10.1111","volume":"8","author":[{"given":"Elizabeth","family":"Chong","sequence":"first","affiliation":[{"name":"University of New South Wales  Randwick NSW Australia"},{"name":"Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School  Randwick NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph J.","family":"Mobbs","sequence":"additional","affiliation":[{"name":"University of New South Wales  Randwick NSW Australia"},{"name":"NeuroSpine Clinic  Randwick NSW Australia"},{"name":"Department of Spine Surgery Prince of Wales Hospital  Randwick NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew H.","family":"Pelletier","sequence":"additional","affiliation":[{"name":"Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School  Randwick NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William R.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School  Randwick NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-015-0546-x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2006.04.003"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/01.BRS.0000048503.51956.E1","article-title":"A prospective randomized comparison of coralline hydroxyapatite with autograft in cervical interbody fusion","volume":"28","author":"McConnell JR","year":"2003","journal-title":"Spine (Phila Pa 1976)"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005860000168"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000197258.30821.50"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200208150-00003"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-003-0539-6"},{"key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/00003086-198506000-00011","article-title":"Carbon fiber debris within the synovial joint. 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